Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STRONGYLOIDIASIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1995

Strongyloides stercoralis: histopathology of uncomplicated and hyperinfective strongyloidiasis in the Mongolian gerbil, a rodent model for human strongyloidiasis [corrected].

Tissues from corticosteroid-treated gerbils hyperinfected with Strongyloides stercoralis were compared grossly and microscopically to similar tissues from animals with uncomplicated strongyloidiasis. Gerbils with hyperinfection developed severe pulmonary alveolar haemorrhage with a variable degree of subacute eosinophilic interstitial pneumonia associated with numerous alveolar, vascular and interstitial larvae. Hyperinfection induced by corticosteroids, given either before inoculation of S. stercoralis larvae or after a chronic Strongyloides infection was established, produced similar lesions. In contrast, lungs from gerbils with uncomplicated Strongyloides infection had severe eosinophilic perivasculitis and vasculitis with very little haemorrhage, no pneumonia and no larvae. Sections of adult worms were present in the proximal part of the intestinal tract, lodged in spaces between mucosal epithelial cells. Adult worms were not associated with inflammation and were more common in the corticosteroid-treated gerbils. In corticosteroid-treated gerbils only, there were numerous larvae in the distal intestinal tract, throughout the intestinal wall and adjacent mesentery, within interstitial tissues and in lymphatic vessels. Significant inflammation with associated larvae was only present in the caecum and mesenteric lymph nodes, suggesting that the caecum was the main site for initiation of parenteral migration with subsequent invasion of the lymphatic system and lungs. The lesions in these gerbils were similar to those found in humans. Infection of gerbils with S. stercoralis is the best rodent model of human strongyloidiasis.

Animals↗
PubMed1993

[Systemic strongyloidiasis. Hyperinfection syndrome and disseminated strongyloidiasis].

Hyperinfection syndrome and disseminated strongyloidiasis are serious complications to the rather harmless upper bowel infection with Strongyloides stercoralis. The infection is endemic in tropical and subtropical climates as well as in many parts of Eastern Europe. Systemic strongyloidiasis occurs mainly in immunosuppressed patients, but apparently not in HIV-patients. The condition has a significant mortality. Early diagnosis and sufficient treatment is essential to reduce the mortality. The treatment is thiabendazole or albendazole. With increased travel and immigration the infection and its complications can also be seen in non-endemic areas. A case report is presented to heighten awareness of this serious condition, which is preventable.

Adult↗
PubMed2002

Human strongyloidiasis in AIDS era: its zoonotic importance.

Human strongyloidiasis is caused by a nematode Strongyloides stercoralis. Many species cause strongyloidiasis in animals. The parasite has predilection to one host only but the host specificity is not strict. When animal species infects humans there is intense allergic reaction in the form of cutaneous larva currens and larva migrans. Therefore, strongyloidiasis in strict terms is a zoonotic disease. The strongyloides species have three stages. The parasitic form inside the host, the free form stage in the soil or water that moults to infective third stage. The later infects the host through skin and migrate to the heart and lung and finally swallowed back to cause intestinal infection. However, in some cases intense pulmonary manifestations may take place. The Strongyloides stercoralis has unique feature of moulting from parasitic form to infective stage within the body, rather than coming out and forming free living stage and causing autoinfection. This may lead to latent infection for indefinite period in an immunocompetant person but fatal hyper or disseminated infection in immunocompromised person like patients of AIDS, organ transplant recipients, cancer and other patients put on immunosuppressive therapy, in whom it can involve any organ of the body. Because this group of patients in last few years have increased tremendously in Africa and South-East Asia, more and more cases of strongyloidiasis are being reported in english literature. The diagnosis of intestinal strongyloidiasis is made by repeated stool smear examinations and in extraintestinal strongyloidiasis the appropriate specimen is examined for the rhabditiform larvae. Recently serological tests have also been developed that can be used for epidemiological purposes. The drug of choice for the treatment of strongyloidiasis remains thiabendazole but due to its unacceptable side effects other medicines like albendazole and ivermectine are being used more frequently. The prevention of the infection is possible by adopting good personal hygiene and safe drinking water supply.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A fatal case of systemic strongyloidiasis and review of the literature.

Systemic strongyloidiasis is a rare but serious complication of intestinal strongyloidiasis. The condition occurs mainly in immunosuppressed patients and has a significant mortality rate. A case of systemic strongyloidiasis is described in a patient who received systemic steroid treatment, and a short review of the literature is given. The increased use of immunosuppressive and cytotoxic treatment necessitates increased awareness of this infection. HIV-infection, however, does not appear to increase the risk of developing systemic strongyloidiasis. Patients from endemic areas and travellers to such areas, even in the remote past, should be examined for strongyloidiasis before being given immunosuppressive treatment. Awareness of the possibility of systemic strongyloidiasis is essential if such a patient develops gastrointestinal or pulmonary symptoms or has repeated episodes of unexplained gram-negative infections while undergoing immunosuppressive treatment.

Adult↗
PubMed2001

HTLV-1 decreases Th2 type of immune response in patients with strongyloidiasis.

Eosinophils, immunoglobulin (Ig)E and cytokines have important roles in defence mechanisms against helminths. In this study, the influence of HTLV-1 infection, characterized by a Th1 type of immune response, was evaluated on the cytokine pattern and parasitic specific IgE response in patients with strongyloidiasis. Patients were divided into four groups: strongyloidiasis without HTLV-1 infection, strongyloidiasis with HTLV-1, HTLV-1 without strongyloidiasis and controls without either helminth infection or HTLV-1. The cytokine profile was determined in supernatants of mononuclear cells stimulated with Strongyloides stercoralis crude antigen and the parasite specific IgE was measured by ELISA. Patients coinfected with HTLV-1 had higher levels of interferon (IFN)-gamma and interleukin (IL)-10 (P < 0.05) and lower levels of IL-5 and IgE (P < 0.05) than patients with strongyloidiasis without HTLV-1. There was an inverse relationship between IFN-gamma and IL-5 (P = 0.01; rs = - 0.37) and between IFN-gamma and parasite specific IgE (P = 0.01; rs = - 0.39), and a direct relationship between IFN-gamma and IL-10 (P = 0.04; rs = 0.35). These data show that coinfection with HTLV-1 decreases IL-5 and IgE responses in patients with strongyloidiasis consistent with a relative switch from Th2 to Th1 response. Immunological responses such as these are important in the control of this helminthic infection.

Adult↗
PubMed1980

Subconjunctival corticosteroid therapy complicated by hyperinfective strongyloidiasis.

A 57-year-old man was treated for a corneal ulcer with a penetrating keratoplasty, followed by six weeks of a regimen of 4 to 8 mg of dexamethasone injected subconjunctivally daily. Before therapy, he was clinically well and 10% eosinophils were noted on his differential white blood cell count. He developed a gastric peptic ulcer with hemorrhage and severe strongyloidiasis of the stomach and duodenum that worsened as the ulcer responded to medical therapy. The strongyloidiasis resulted in physiologic gastric outlet obstruction by decreasing gastrointestinal motility. There was evidence of hyperinvasive and disseminated strongyloidiasis, complicated by meningitis and Serratia marcescens bacteremia. He survived and received thiabendazole treatment for strongyloidiasis, which was successful. Subconjunctival corticosteroids caused a systemic effect that changed asymptomatic Strongyloides infection into hyperinvasive strongyloidiasis.

Conjunctiva↗
PubMed1983

Immunological features in different clinical forms of strongyloidiasis.

Serum immunoglobulin levels, skin test response to PPD, lymphocyte surface markers and eosinophil count in peripheral blood were studied in 35 patients with strongyloidiasis diagnosed by stool examination. The patients were divided into three groups based on clinical history, physical examination and laboratory examination: an asymptomatic group (14 patients), a symptomatic group (14 patients) and a group with severe parasitic infection (seven patients). In three of the seven patients with severe strongyloidiasis, massive infection caused by Strongyloides stercoralis had been diagnosed at least once before this study. The IgG levels were significantly lower (p less than 0.05) in patients with severe strongyloidiasis (1180 +/- 529 mg/dl) than in the asymptomatic group (2347 +/- 1224). IgA and IgM levels were also lower in the patients with massive infection when compared to the asymptomatic and symptomatic groups. No decrease of T cells or B cells was found in patients with severe strongyloidiasis. However, the eosinophil count was significantly lower in patients with severe strongyloidiasis than in asymptomatic or symptomatic patients (p less than 0.05). The authors suggest that eosinophils and antibodies may play an important role in the defence mechanism against S. stercoralis larvae.

Adolescent↗
PubMed1999

Strongyloidiasis as a possible cause of nephrotic syndrome.

Chronic strongyloidiasis is a mild disease and has never been reported to be associated with nephrotic syndrome. Disseminated strongyloidiasis is known to have high mortality, but it frequently is not diagnosed until autopsy. We report a patient with nephrotic syndrome developing disseminated strongyloidiasis after steroid therapy. The findings in renal biopsy, the time course of the development, and resolution of nephrotic syndrome after thiabendazole treatment suggested a possible causal relationship between chronic strongyloidiasis and nephrotic syndrome. The case also demonstrated the importance of early diagnosis in disseminated strongyloidiasis and the good clinical outcome of early treatment before the development of organ failure.

Duodenum↗
PubMed1995

Strongyloidiasis in patients with hematologic malignancies.

We retrospectively studied 343 consecutive patients treated between 1979 and 1992. Ninety patients whose stool was not examined were excluded. Fifty-three patients with strongyloidiasis were compared with 200 controls with regard to outcomes and the following characteristics: age, sex, underlying disease, use of corticosteroids, abdominal pain, diarrhea, fever, pulmonary symptoms, and eosinophilia. Patients with strongyloidiasis more commonly had eosinophilia (P = .01) and fever (P = .03). There was a single but fatal case of the disseminated disease syndrome (1.9% of patients with strongyloidiasis). In multiple logistic regression analysis, the factors predictive for strongyloidiasis were schistosomiasis (odds ratio [OR], 6.58), ascariasis (OR, 2.78), and the use of steroids (OR, 2.29). Strongyloidiasis was highly prevalent among patients with hematologic malignancies in Brazil. Occurrence of the disseminated disease syndrome seems to be unusual.

Adolescent↗
PubMed1981

Diagnosis of human strongyloidiasis by immunofluorescence, using Strongyloides ratti and S. stercoralis larvae.

The sensitivity and specificity of an indirect immunofluorescent antibody assay for the diagnosis of human strongyloidiasis has been investigated. Sera were obtained from 160 Australian ex-servicemen who had been prisoners-of-war in Southeast Asia during World War II, 44 of whom proven parasitologically to have strongyloidiasis; these men did not have concurrent infections with other helminths. In addition, sera were collected from 44 age- and sex-matched Australians who were not thought to have been exposed to S. stercoralis, and from 44 Filipino subjects. Antibodies were measured by using living filariform S. ratti larvae as the source of antigen. The assay was highly sensitive; antibodies were found at a titer of 1:4 or greater in 98% of men with strongyloidiasis and in 2% of Australian control subjects. Fifteen percent of exposed ex-servicemen in whom parasites had not been found had antibody titers of 1:4 or more, and it is thought that they had cryptic infections. Incubation of pooled positive sera with soluble S. ratti antigen produced a marked fall in antibody titer, but no changes were seen after incubation with soluble Ascaris suum or Dirofilaria immitis antigens. It is thought that this indicates that the test is specific and that the 84% of Filipinos with antibody titers of 1:4 or greater had unsuspected strongyloidiasis. When antibody titers against S. ratti were compared with those obtained using living filariform S. stercoralis larvae, a high correlation was found (r = 0.89, P less than 0.001). It is concluded that this assay provides a simple, safe, and specific method for the diagnosis of strongyloidiasis.

Adult↗
PubMed2000

Pulmonary strongyloidiasis--case report of 2 cases.

Strongyloidiasis is a benign gastrointestinal infection. It can pass through the lungs and induce pulmonary strongyloidiasis. The suspicion of pulmonary involvement begins with clinical and chest radiographic features in the patients at risk. They are as follows: chronic lung diseases, age was 65 years, altered cellular immunity, and use of corticosteroids. Definitive diagnosis is made by identification of strongyloides in the secretion or tissue of the respiratory tract. We present 2 patients with pulmonary strongyloidiasis in this research. These 2 cases were patients with chronic obstructive pulmonary disease; both patients were more than 65 years old. They had the risk factors for severe strongyloides infection (advanced age, use of corticosteroids, an high serum cortisol level), worsening of pulmonary symptoms (e.g., dyspnea, cough, sputum production) and abnormal radiographic findings. Strongyloides stercoralis was found in the sputum and stool, and pulmonary strongyloidiasis was diagnosed. Mebendazole 100 mg twice daily was used and this eliminated the parasite from the stool in case 1, and from the sputum in case 2. Unfortunately, there was a relapse of parasite infection in case 1 and it also induced pulmonary strongyloidiasis. Finally, he died of respiratory failure. Since this disorder has a high relapse rate (15%), serial follow-up of stool and sputum is very important.

Aged↗
PubMed1989

[Comparative study of thiabendazole and mebendazole in strongyloidiasis].

Taking into consideration some statements about better efficacy and good tolerability of mebendazole and since thiabendazole has not been produced in our country the past few years we have conducted a study evaluating mebendazole, in comparison with thiabendazole in the treatment of patients with strongyloidiasis. Strongyloidiasis is a disease that should be treated with an effective and active drug since it can rapidly progress and be fatal in patients with disturbed immunocompetence. One hundred and ten patients with strongyloidiasis were treated with oral thiabendazole in a dosage of 50 mg/kg daily for two days; the other group of 41 patients was given mebendazole in a dosage of 10 mg/kg/day orally for five days. Clinical evaluations, parasitologic and hematologic tests were performed within three months after the therapy. Patients were considered to have been cured if parasitologic findings were negative and abnormal blood eosinophilia decreased below 0.09 (733/microliters). According to these criteria thiabendazole was effective in 96.4% of patients and mebendazole in 44% of patients only. We conclude that thiabendazole has still to be regarded the drug of choice in treating patients with strongyloidiasis. Mebendazole is far less effective in patients with this helminthiasis and very probably only suppresses the infection. The reports of other studies on the effect of some of the newer benzimidazole antihelmintics as cambendazole, albendazole and flubendazole have shown that they are toxic or less effective in the treatment of strongyloidiasis.

Humans↗
PubMedDate not supplied

Clinical, immunological and epidemiological aspects of strongyloidiasis in an endemic area of Brazil.

Eighty-eight residents of Curitiba, Brazil, with parasitologically proven Strongyloides stercoralis infection were assessed clinically and evaluated for their specific and non-specific responses to the parasite. A control group of 73 patients with other intestinal parasites, but with negative stools for S. stercoralis were also evaluated. Abdominal symptoms and/or weight loss were present in 24% of the patients with strongyloidiasis and in 25% of the patients with other parasites only. Elevated peripheral eosinophilia (greater than 5%) was present in 68% of the patients with strongyloidiasis (mean = 10.6%) and in 73% of the individuals with other parasites only (mean = 8.8%). Total serum IgE were elevated (greater than IU/ml) in 84% of the patients with strongyloidiasis (mean = 2872 IU/ml), and in 79% of the patients with other parasites only. Over 90% of the patients with proven strongyloidiasis had detectable levels of parasite specific IgG and IgE antibodies, as detected by the ELISA and the RAST, respectively. These antibodies were present in 23% of the individuals in whom fecal examinations had failed to reveal S. stercoralis. We conclude that in an endemic area, gastrointestinal manifestations and non-specific indicators of parasitic infections, such as elevated peripheral eosinophilia and total IgE, are not useful indexes of the presence of strongyloidiasis. Immunoserologic tests, such as the ELISA and the RAST may represent sensitive and specific tools for the screening of candidates for immunosuppression and for gathering needed epidemiological information about this increasingly important opportunistic nematode.

Adolescent↗
PubMed1993

The efficacy of two electron transport inhibitors (720C80 and 993C76) on murine strongyloidiasis: a comparison with albendazole.

The clinical efficacy of albendazole (ABZ) in the treatment of chronic uncomplicated strongyloidiasis has been reported to be highly variable. In our murine model of strongyloidiasis a single oral dose of 5 and 10 mg kg-1 ABZ reduced (at day 4 post infection) the faecal larval count (FLC) by 54.2 +/- 12.5% and 81.5 +/- 10.2%, respectively. 100 mg kg-1 ABZ reduced the FLC by 100%. Two inhibitors of protozoan and filarial electron transport (720C80 and 993C76) inhibited the endogenous O2 consumption of intact infective (L3) larvae of S. ratti by > 50% at 2 x 10(-5) M in vitro, and reduced the FLC by 72 +/- 9.3% and 62.0 +/- 10.3% respectively in vivo, at a dose of 70 mg kg-1. These results suggest that compounds designed as selective inhibitors of protozoan electron transport have significant efficacy against murine strongyloidiasis and may prove useful in the management of human strongyloidiasis.

Albendazole↗
PubMed1976

A fatal case of strongyloidiasis with Strongyloides larvae in the meninges.

A case of fatal strongyloidiasis associated with pyogenic meningitis in an adult male African is reported. Strongyloides larvae were present in the purulent exudate in the the meninges, an observation not, to the authors knowledge, hitherto reported in man. Fatal strongyloidiasis due to autoinfection has been reported by several authors and De Paula (1962) reviewed the literature in 40 cases and added 10 others which he had studied. In Uganda fatal cases have been reported by Craven et al. (1971) and Poltera (1974). Although in some cases of fatal strongyloidiasis there was associated pyogenic meningitis (BROWN & PERNA, 1958; WILSON & THOMPSON, 1964; BASSAN-TREMINGER & EL-LANSHAR, 1968) we have not found in the literature any case in which Strongyloides stercoralis larvae or adult worms were found in the brain or meninges. We are, therefore, now reporting a case of fatal strongyloidiasis with pyogenic meningitis in which S. stercoralis larvae were present in the subarachnoid space.

Humans↗
PubMed1981

Serodiagnosis of human strongyloidiasis by an enzyme-linked immunosorbent assay.

The sensitivity specificity of an enzyme-linked immunosorbent assay (ELISA) for the serodiagnosis of strongyloidiasis has been investigated. 45 men with long-standing strongyloidiasis were compared with the same number of age- and sex-matched control subjects. The ELISA detected antibody in 84% of patients with parasitologically proven strongyloidiasis. When the technique was compared with an indirect immunofluorescent assay (IFA), a high correlation coefficient was obtained. Specificity was demonstrated by observing a marked fall in optical density of pooled positive serum after prior incubation with Strongyloides ratti soluble antigen but not after incubation with antigens derived from Ascaris suum or Dirofilaria immitis. The test is simple and offers a useful method for the diagnosis of strongyloidiasis. In these patients it was more reliable than a single parasitological examination of faeces or duodenal contents.

Antibody Specificity↗
PubMed2000

High circulating proviral load with oligoclonal expansion of HTLV-1 bearing T cells in HTLV-1 carriers with strongyloidiasis.

Adult T cell leukemia (ATLL) develops in 3 - 5% of HTLV-1 carriers after a long period of latency during which a persistent polyclonal expansion of HTLV-1 infected lymphocytes is observed in all individuals. This incubation period is significantly shortened in HTLV-1 carrier with Strongyloides stercoralis (Ss) infection, suggesting that Ss could be a cofactor of ATLL. As an increased T cell proliferation at the asymptomatic stage of HTLV-1 infection could increase the risk of malignant transformation, the effect of Ss infection on infected T lymphocytes was assessed in vivo in HTLV-1 asymptomatic carriers. After real-time quantitative PCR, the mean circulating HTLV-1 proviral load was more than five times higher in HTLV-1 carriers with strongyloidiasis than in HTLV-1+ individuals without Ss infection (P<0.009). This increased proviral load was found to result from the extensive proliferation of a restricted number of infected clones, i.e. from oligoclonal expansion, as evidenced by the semiquantitative amplification of HTLV-1 flanking sequences. The positive effect of Ss on clonal expansion was reversible under effective treatment of strongyloidiasis in one patient with parasitological cure whereas no significant modification of the HTLV-1 replication pattern was observed in an additional case with strongyloidiasis treatment failure. Therefore, Ss stimulates the oligoclonal proliferation of HTLV-1 infected cells in HTLV-1 asymptomatic carriers in vivo. This is thought to account for the shortened period of latency observed in ATLL patients with strongyloidiasis. Oncogene (2000) 19, 4954 - 4960

Adult↗